Predictors of therapeutic response to peginterferon α‑2a and nucleos(t)ide analog combination therapy for HBeAg‑negative chronic hepatitis B: 1‑year follow‑up after treatment

Abstract

Chronic hepatitis B (CHB) is a major global health concern. Guidelines for the management of hepatitis B virus (HBV) indicate that the loss of hepatitis B surface antigen (HBsAg) is a key endpoint of interest. The present study aimed to examine long‑term changes in HBsAg levels in HBV‑DNA‑negative, hepatitis B e‑antigen (HBeAg)‑negative patients treated with peginterferon (Peg‑IFN) α‑2a and nucleos(t)ide analog (NA), and to examine the conditions that make them susceptible to HBsAg decline. A total of 17 patients with CHB treated with NA and Peg‑IFN were observed for 96 weeks (48 weeks of Peg‑IFN therapy and 48 weeks of post‑treatment follow‑up). In this study, responders were defined as those with a 50% or greater decrease in HBsAg levels from baseline at week 96. Beginning at week 16 of Peg‑IFN therapy, there was a significant difference in the decrease in HBsAg levels from baseline between the responders and non‑responders. In responders, HBsAg levels tended to be >60% lower 16 weeks after Peg‑IFN initiation than before initiation. Age at the start of NA use and the duration of NA use before Peg‑IFN treatment initiation were significant pretreatment factors associated with HBsAg response. In conclusion, Peg‑IFN was revealed to be more effective in HBeAg‑negative patients with CHB who started NA at a young age and have been on long‑term treatment, particularly if the HBsAg levels decreased to less than 60% of the starting level at week 16 after starting Peg‑IFN treatment.